Date of Award

2015

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of this selective EBM review is to determine whether or not the addition of oxaliplatin to 5FU and leucovorin will improve disease free survival of patients with stage III colon cancer who had surgical resection of the tumor.

Study Design: Review of three published, double blind randomized control trials in the English language in 2004, 2007, and 2009.

Outcomes Measured: The outcome is disease free survival of colon cancer. It is measured using periodic patient follow-up. History and PE, neuro assessment, liver and kidney function tests, CEA test, CBC, and imaging studies such as colonoscopy or barium enema are some of the assessments done at follow-up.

Results: All three articles used found similar results in that oxaliplatin is effective when added to 5FU and leucovorin. The first study has an average follow-up of 42.5 months and a disease free survival of three years. The numbers needed to treat (NNT) was twenty-four. The number need to harm (NNH) was ten for all three of the articles. The second article had an average follow-up of 81.9 months and a five year disease free survival. The NNT was seventeen. The last article used had an average follow up at 37.9 months and a disease free survival of three years. The NNT was nineteen.

Conclusions: The addition of oxaliplatin to 5-fluorouracil (5FU), and leucovorin does improve disease free survival of patients with stage III colon cancer who had surgical resection of the tumor.

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